LUCAS COUNTY REGIONAL HEALTH DISTRICT Board of Health Meeting Department of Operations Center (DOC) #254 October 23, 2014 8:30 A.M. Roll Call A roll call was taken of Board members for attendance. Present: Darlene Chaplin, Barbara Conover, Reynald Debroas, Mary Duncan, Perlean Griffin, Matthew Heyrman, Donald Murray, Robert Reinbolt, Barbara Sarantou, Hans Schmalzried, Dr. Christopher Sherman, Dr. Donna Woodson Guests: Cindy McLeod, ONA Representative; Nate Fries, Union Steward, AFSCME; Kevin Pituch, Assistant Prosecutor; Zyishia Bailey; Richard Addo, and Avani Shah, Students, University of Toledo Medical College; Katie Remig, Intern, UTMC Infection Control Staff: Clark Allen (for Barbara Gunning), Jerry Bingham, Mary Frank, Dr. David Grossman, Joanne Melamed, Larry Vasko, Eric Zgodzinski Dr. Donna Woodson, President, called the meeting to order. Introduction of Guests Larry Vasko introduced Cindy McLeod, Nate Fries, Kevin Pituch, Zyishia Bailey, Richard Addo, Avania Shah, Katie Remig, Clark Allen, and Jerry Bingham Minutes of September 25, 2014 The minutes of the September 25, 2014 meeting were reviewed. Matt Heyrman suggested and it was agreed that he would clarify paragraph five under the Environmental Health Issues Committee report relative to the sewage rules. The following changes were made: On page three, under Cost Methodology, line three, change: fees will be eliminated to: fees may be eliminated On page six, under Community and Environmental Health Services report, change from: the environmental health is going to change in the near future to the programs in Environmental Health are going to change in the near future. On page seven, last line, add the words: has risen. There was agreement. Perlean Griffin made a motion to approve the minutes with corrections and additions. Donald Murray seconded the motion. A vote was taken of those present. Motion carried. Agenda Dr. Donna Woodson noted a request to hold an executive session today to discuss contractual items. This item will be placed on the agenda after the Audit/Finance Committee report. There was agreement. 1
Vouchers Dr. Christopher Sherman said that the Audit/Finance committee met on October 21. Board members reviewed the Bill Schedule. Dr. Sherman referenced page two of the Bill Schedule relative to the purchase of a van in the amount of $26,658.50 for the Mobile Vision Program. The van was purchased from Dave White Chevrolet without prior notification to the Board of Health. A Then and Now was requested as the van was delivered. The committee discussed this item at length. Consequently, the committee requested that over the next year it would randomly audit a purchase at the Board of Health meeting to assure compliance with the policy. The committee had selected one item for today s report. Joanne Melamed will report on this item under the Administrative Services report. The committee found the Bill Schedule to be satisfactory and recommended approval. Barbara Conover made a motion to approve the payment of the October vouchers. Barbara Sarantou seconded the motion. A vote was taken: 12 yeas, 0 nays. Motion carried. Old Business Follow-Up Items Federally Qualified Health Center (FQHC) Dr. David Grossman provided an update on Federally Qualified Health Center (FQHC). This is an ongoing project with much activity. The FQHC application was submitted in a timely manner, before the October 7 deadline. Dr. Grossman mentioned that he had attended a Board meeting of the Dental Center of Northwest Ohio yesterday. The Dental Center has shown an interest to partner with the Health Department with our FQHC status. If for some reason the Health Department does not secure FQHC status, it will likely secure an FQHC Look Alike and that would enable us to start receiving enhanced reimbursements. This item will be part of the budget discussion at the next Audit/Finance Committee meeting. Prosecutor s Update Kevin Pituch reported on Ebola, which is currently in the news. The legal ramifications of Ebola and Board of Health options were presented. The Ohio General Assembly grants the Board of Health and the Health Commissioner much power in terms of what steps to take if an individual has Ebola or another type of infectious disease. The Health Commissioner can order the person to be quarantined, including other occupants residing in the same household. A Quarantine police force may also be employed. Other authority includes inspection of property without a warrant, destruction of private property, etc. However, there is a need to be mindful of personal liberty and the right to privacy. Dr. Grossman noted that the issue of Quarantine was examined several years ago regarding a SARS incident; however, it was not pursued at that time. The Board discussed the issue of monies in these types of situations. Larry Vasko explained that two pools of money have been aside by the State of Ohio, the first to help with the treatment of medical waste and disposal of contaminated equipment. The second pool of money could be used to purchase more PPE and to resupply as needed. 2
Kevin Pituch explained that locally there is authority by statute to use the money on a first come basis as needed. There is also authority to go into a municipality s budget and pull funds if necessary. Matt Heyrman stated that he would advocate the expenditure of said money right away in an emergency-type situation. New Business ABLE Lead Ordinance Dr. David Grossman reported that a meeting was held with Attorney Bob Cole from ABLE regarding the Lead Ordinance that will be presented to the City of Toledo. There is a State law that almost mimics the proposed Lead Ordinance; however, it is under a different title. Consequently, Mr. Cole had to go back and change the definition on the original document. This led to a delay in the Lead hearing. We have indicated our commitment to do whatever it takes to obtain passage of this important ordinance. We will continue our conversations with Mr. Cole. Robert Reinbolt requested a copy of the State law for review. Dr. Grossman noted that all Board members would receive a copy. Confirmation of New Employees Larry Vasko reported that Zyishia Bailey was hired as a Health Educator on October 26, 2014 at a rate of $16.97 per hour. There were no separations. Robert Reinbolt made a motion to accept the report. Matt Heyrman seconded the motion. A vote was taken: 12 yeas, 0 nays. Motion carried. Environmental Health Issues Committee Donald Murray reported that the committee did not meet this past month. However, today there will be a second reading on the Environmental Health fees. At the next Board meeting there will be a third reading of the proposed fees and a public hearing. The general public will be notified and invited to attend. Mr. Murray asked for a motion to accept the second reading of the Environmental Health Fees. Robert Reinbolt made a motion to put this item on the table for discussion. Matt Heyrman seconded the motion. A vote was taken: 12 yeas, 0 nays. Motion carried. Matt Heyrman said that we continue to work with the Administration about the annual operational permit. A major concern is that next month a final reading will take place and there is uncertainty about issues surrounding an annual operational maintenance program and a fee-based structure. Eric Zgodzinski said that he would ask Kevin Pituch to look at this issue relative to running the program and asking for a fee, but not conducting an inspection for 3 to 5 years. He noted that other health departments are doing this. He said that he would prepare a procedure/document to ensure viability. 3
The Board discussed the issue of an Operation & Maintenance (O&M) Program at length. Matt Heyrman asked the Board to consider the impact to people who do not have septic tanks vs. those who do. Mr. Heyrman indicated his support for an OMP program and urged a survey of the entire community regarding septic tank locations. Proposed 2015 Environmental Fees Second Reading Robert Reinbolt made a motion that the Board approve a second reading of the 2015 Proposed Environmental Health Fees. Donald Murray seconded the motion. A roll call vote was taken: 12 yeas, 0 nays. Motion carried. Personnel Committee Robert Reinbolt reported that the committee met on October 21, 2014 and discussed the following issues: Manpower, New Positions (Account Clerk and Webmaster), Disciplinary Action and Travel Policy. Manpower The committee discussed adding positions resulting from increased grant funding. There are 2 additional positions funded by the CFHS grant, and 7 additional positions funded by the Maternal Child Health grant. The committee questioned if these positions were using existing job descriptions and established pay rates. Administration confirmed that they were so these recommendations were accepted pending review by the Audit/Finance Committee. New Positions Administration requested two new Account Clerk positions for the front desk. There is an existing classification in the AFSCME contract and a job description has been updated in accordance with Accreditation standards. These positions would replace the Medical Assistants currently assigned to the front desk. The cost would be $89,423.30. The committee reviewed the new job descriptions and suggested some changes. With these incorporated, the committee recommended Board consideration subject to Audit/Finance Committee review, since these positions were not in the approved budget, but funding is available. Administration also requested a new position of Webmaster be added to the Information Technology department. The new position is classified in the non-bargaining unit as an E-1. This position would be responsible for design, implementation, maintenance, and updating the Health Department s website. The cost would be $59,570.28. Committee members approved the job descriptions for these positions subject to the Audit/Finance Committee review for available financing and if we would be better to outsource this service or use a temporary service, at least at first. Dr. Grossman noted advantages for the new Webmaster position and updating the Health Department website. This would include daily updates, daily reports on current issues (Ebola), weekly reports (DAC), application for licenses (restaurant, birth and death records), programs (O&M), etc. 4
Disciplinary Action Dr. Grossman discussed a potential termination. No action needed. Travel Policy Mr. Reinbolt suggested two changes to the Travel Expense Policy. The first suggestion is to require employees traveling to the same conference with an overnight stay to share a room, assuming that they are of the same sex. Employees would be reimbursed for 50% of the room rate if they prefer not to share. The second suggestion is to require travel out of Toledo Express airport where at all possible. Administration discussed the reasons against sharing a room and noted most overnight travel is mandated and paid by grant dollars. After some discussion on this issue the committee DID NOT recommend any change in policy. It was agreed, however, to adopt language from the City of Toledo s Travel Policy for encouraging use of Toledo Airport for travel. If air transportation is utilized for travel, then the employees shall explore the option of utilizing Toledo Express Airport. If the cost of a flight is within 3 hours of travel time each way and within $100 of the price of the lowest priced ticket at another airport, then the employee will be required to use the Toledo Express Airport unless use of another airport is authorized by the Health Commissioner. Action will be required by the Board to accept this modification of the policy and to approve the policy in the new format. The Personnel Committee, Audit/Finance Committee and Administration support this item. Motion Donald Murray made a motion to approve two Accounting Clerk positions. Perlean Griffin seconded the motion. A vote was taken: 12 yeas, 0 nays. Motion carried. Motion Dr. Christopher Sherman made a motion to approve the amended Travel Policy as presented. Perlean Griffin seconded the motion. A vote was taken: 12 yeas, 0 nays. Motion carried. Dr. Christopher Sherman made a motion to approve the report. Perlean Griffin seconded the motion. A vote was taken: 12 yeas, 0 nays. Motion carried. Facility Committee Robert Reinbolt reported that the committee did not meet this past month. Larry Vasko reported that a meeting took place with Steve Katich from Marcy Kaptur s Office regarding our facility, the new court facility, and our parking needs. We have engaged with Tetra Tech for preliminary studies relative to increasing parking in our front parking lot. It is anticipated that the new Federal Court House would be built in 2018 behind the Health Department Building. The expansion of our parking lot would cost about $400,000 and funds 5
would come from the General Fund. We anticipate receipt of additional information including the layout of our building relative to parking sometime this month. We hope to include this item, if not in this year s budget, then next year. Mr. Vasko noted that Steve Katich had indicated his support of our FQHC status. He liked what we were doing in that area as well as our potential. Dr. Grossman noted that the Health Department roof is slated for repair. Audit/Finance Committee Dr. Christopher Sherman reported that the committee met on October 21, 2014 and reviewed the following items: September 2014 Financial Status, October Bill Schedule, Grant Funded Programs, Contracts, Transfers of Appropriations and other items Purchasing Policy, New Positions, Travel Policy Grant Funded Programs Total applications in the amount of $4,597,653 for 2014 fiscal years and during this same time period we were awarded $4,381,721 in funding. Total applications in the amount of $9,017,211 for 2015 fiscal years and during this same time period we have been awarded $6,520,521 in funding. We received one notice of award: 1. Local Office of Minority Health - $67,500 We have 9 pending grant applications: 1. Immunization Action Plan Application - $161,165 2. Dental Sealant Program - $75,000 3. Sexually Transmitted Disease - $49,238 4. HIV Prevention - $285,039 5. Sixty Plus Clinic - $53,850. Requires 100% match from the General Fund. 6. Safety Net - $75,000 7. Creating Healthy Communities -$125,000 8. Partnership to Improve Community Health - $47,970 9. Affordable Care Act New Access Point for an FQHC Application - $650,000 Review Contracts There are 8 contracts in the months of August/September: 1. University of Toledo (Pathway Project Community Health Care Worker) - $41,040 2. FQHCmd Consulting - $29,500 3. Stericycle - $308 4. Mercy St. Vincent Medical Center (WIC) - $508,112 5. Neighborhood Health Association (WIC) - $349,922.65 6. ProMedica Toledo Hospital - $385,164 7. Commission on Minority Health - $7,500 8. Hospital Council of Northwest Ohio (CHIP) - $7,500 Other Items Transfers of Appropriations 6
A transfer reallocates funds from one cost object to another. Board of Health Resolution is required to approve Transfers of Appropriations performed in the months of September 2014 in the ordinary course of business. Total of transfers was for $82,299.38, consisting of changes in various expense categories. Donald Murray made a motion to approve the resolution as read. Robert Reinbolt seconded the motion. A vote was taken: 12 yeas, 0 nays. Motion carried. There are no changes to report in Revenue Estimates and Expense Appropriations in September 2014. (No motion is necessary.) Other Items Purchasing Policy, New Positions, Travel Dr. Sherman noted that these items have already been covered. Robert Reinbolt inquired about the recent purchase of a van for the Health Department. He asked if everyone was comfortable with the policy now in place and assurance that the occurrence that happened with the purchase of the van would not happen again. Dr. Sherman replied that a monthly line item would be selected for Board review. We would oversee the process, making sure proper bids are taken and proper documentation is done. Dr. Grossman felt there is no need to change the current policy. He noted that there was some miscommunication with the purchase of the van. He assured that this type of event would not happen again. The only other part to clear was on purchase items of over $50,000, which was in part taken for granted. However, that was included under our governmental policy. It was understood by all. The minutes should reflect that this is the exemption we are using for that particular purchase. Robert Reinbolt made a motion to approve the report. Donald Murray seconded the motion. A vote was taken: 12 yeas, 0 nays. Motion carried. Executive Session Mary Duncan made a motion that the Board go into executive session to discuss a contractual issue. Perlean Griffin seconded the motion. A roll call vote was taken: 12 yeas, 0 nays. Motion carried. Robert Reinbolt requested that only Board Members stay for the executive session. There was agreement. The Board went into executive session at approximately 10:20 A.M. and returned at approximately 10:50 A.M. Contracts There were no additional contracts. DIVISION REPORTS Community and Environmental Health Services Eric Zgodzinski reported as follows: 7
Ebola It has been Ebola for 24/7 for the past weeks. An overview of items being worked on include: communications, daily meetings, daily conference calls, and other items. Kudos has come to Ohio regarding the issue of Quarantine and how we deal with individuals who might have had contact with infected persons regarding Ebola. There was good leadership from the Ohio Department of Health. There was stepped up demand for individuals to be checked and quarantined if necessary. Ohio was one of the first states to be recognized in this endeavor. Mr. Zgodzinski presented an overview (powerpoint) on Ebola to all Board Members. The Health Department continues to be proactive in educating the public about Ebola and other contagious diseases. We are providing PPE Training, meeting with first responders and other agencies, covering topics, such as, Quarantine issues, response, transportation of patients and other items. Mr. Zgodzinski noted that area hospitals have all agreed that the Health Commissioner would be the spokesperson on Ebola in Lucas County. Health Services Clark Allen, WIC Supervisor, reported for Barbara Gunning. A video clip on health service announcements was presented. This featured a five-year $750,000 HRSA grant, which April Snelling has secured. Two public service announcements were also presented. One dealt with a Bridges presentation with Doni Miller, Dennis Hicks, and April Snelling regarding safe sleep initiatives. The second one dealt with Healthy Communities and the expansion of a Healthy Corner location. Tony Maziarz, Health Educator, composed the video and did an excellent job. Also, WIC held a symposium at Mercy Hospital last week. There were speakers from United Way, Job and Family Services and the Milk Bank (Columbus). Staff members Patti Fraker presented on Ebola and Mary Jay presented on Human Trafficking at the symposium. (Matt Heyrman left at approximately at 11:00 a.m.) Administrative Services Joanne Melamed reported as follows: Facility Update An update on facilities was previously provided. The Health Department roof will likely be repaired this year at approximately $30,000. We met with Steve Katich, from Marcy Kaptur s Office, regarding parking lot expansion, Federal Court House project (funding and timelines), future expansion of clinics, and federal funding for continued building improvements. IT Update The IT staff has completed Dentrix Enterprise 8.0 software configurations and training for our dental clinic staff. Laptops are being used to connect to our main servers through Wi-Fi and secure VPN connections to the Lucas County network. We collaborated with TPS Schools for Wi-Fi access. 8
Purchase (Vendor) for Review At the last Audit/Finance Committee meeting, the committee chose Leaf Capital Funding, LLC as the vendor to review for this month. This is a copier/lease account for the entire department for the month of October. Documents for review included: Bill Schedule, Account Payable Expense Listing, Super Blanket Purchase Order, Then and Now and a copy of the Lease Agreement. Similar documentation is provided to the Auditors for their review. Dr. Christopher Sherman said that these are the documents that the Audit/Finance Committee had randomly selected for review. Policies Lastly, 8 financial policies and 5 Human Resources and Agency Policies were presented for Board approval. Board members had provided input and appropriate changes were made to the original policies. Motion Robert Reinbolt made a motion that the Board approve the policies as presented. Barbara Conover seconded the motion. A vote was taken: 11 yeas, 0 nays. Motion carried. Health Commissioner s Comments Dr. David Grossman commented as follows: Farmer s Market Recently, there were several issues at the Farmer s Market, but they are being rectified. FQHC If the Health Department does not become an FQHC, we would have to re-examine our clinic business status. We are glad to report that the City of Toledo, the Ohio Department of Health and Marcy Kaptur s Office have all shown their support for our FQHC status. It is apparent that the Health Department role is changing once again. We continue to work on accreditation and hope to gain that status within the next year. Flu Shots We continue to encourage everyone to get a flu shot. Harm Reduction The City of Oregon has recently signed up for the Naloxone training program, which the Health Department is making available to all law enforcement countywide free of charge. We have also reached out to Holland, Sylvania, Sylvania Township and others. House Bill 92 Syringe Exchange Program (SEP) It does not look like the Senate will pass this Bill this year. We hope it will pass next year. Other Items 9
Board of Health Training Larry Vasko noted that a recent State law had passed regarding an omnibus bill that requires all Board members to have at least two hours of training annually. All Board members received a CD on Board member training from the Ohio Association of Boards of Health. Board members were urged to take the CD home for viewing to receive proper credit. The CD covers 8 topics on various aspects of Board functions and governance. New Procedures (Ebola) Donald Murray announced a new procedure when persons dial 911. People will be asked to answer additional questions relative to their health status. Persons will be asked if they had traveled to Ebola stricken areas or had any contact with others who traveled to those areas. There will also be escalating levels of response. If an Ebola-type symptom is found, there will be an additional level of response. If there is a worse-case scenario, persons may receive a HAZMAT response from the fire department. These are temporary measures. Larry Vasko pointed out that persons who would be under quarantine for Ebola or monitored would be required to disclose that information to the EMS Dispatcher. Next Meeting Last month, the Board agreed to combine the November and December Board meetings. The date chosen was December 11, 2014 due to financial reporting deadlines. The next regular Board of Health meeting will be held on Thursday, December 11, 2014 at 8:30 a.m. at the Health Building, Department Operations Center (DOC) #254, 635 N. Erie Street, Toledo, Ohio. Adjournment Donald Murray made a motion to adjourn the meeting. Barbara Conover seconded the motion. The motion passed unanimously. The meeting adjourned at 11:50 a.m. 10
Signed: Dr. Donna A. Woodson, President Lucas County Regional Health District Attested By: David Grossman, M.D. Secretary to the Board 11